| NPI | 1639614563 |
|---|---|
| Former Name | FAYE ANN COLOM |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MS 901827) |
| Additional Taxonomies | 405300000X Prevention Professional (Licence: MS 901827) |
| Enumeration Date | 2017-01-02 |
| Last Update Date | 2024-06-06 |